Stack, Brendan Curran
Stack, Brendan Curran is an individual health care provider with primary practice located at 720 N Bond St , Springfield IL 62702-4952. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck. Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck is his primary health care specialty. Stack, Brendan Curran can be contacted via phone (217) 545-8000.Contact Information
Primary practice address
720 N Bond St
Springfield IL 62702-4952
Phone: (217) 545-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | E4564 | Arkansas |
| Allopathic & Osteopathic Physicians / Facial Plastic Surgery | 207YS0123X | E4564 | Arkansas |
| Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck | 207YX0007X | E-4564 | Arkansas |
| Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck | 207YX0007X | 036-151806 | Illinois |
Profile Details
| NPI number | 1437165164 |
|---|---|
| LBN Legal business name | Stack, Brendan Curran |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 1st, 2006 |
| Last updated | Feb 19th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437165164 | NPPES |
| Arkansas | Other | T2005-275 | TRICARE |
| Arkansas | Other | 0507002300 | TRICARE |
| Arkansas | Other | 5N281 | TRICARE |
| Arkansas | Other | 5N2817666 | TRICARE |
| Arkansas | Other | E4564 | TRICARE |
| Arkansas | MEDICAID | 158045001 | TRICARE |
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